Qualitative Determination of Human Chorionic Gonadotropin in Vaginal Washings for the Early Diagnosis of Premature Rupture of Fetal Membranes

• Published in: Revista Brasileira de ginecologia e obstetrícia 2017-07, Vol.39 (7), p.317-321
• Main Authors: Dartibale, Camila Buziquia, Uchimura, Nelson Shozo, Nery, Luiz, Schumeish, Angelita Polato, Uchimura, Liza Yurie Teruya, Santana, Rosangela Getirana, Uchimura, Taqueco Teruya
• Format: Article
• Language: English
• Subjects: Chorionic Gonadotropin, beta Subunit, Human - analysis; Cross-Sectional Studies; diagnosis; Early Diagnosis; Female; Fetal Membranes, Premature Rupture - diagnosis; human chorionic gonadotropin; Humans; obstetrics; OBSTETRICS & GYNECOLOGY; Original; Pregnancy; pregnancy complications; premature rupture of fetal membranes; Prospective Studies; Therapeutic Irrigation; Vagina - chemistry; β subunit
• ISSN: 0100-7203; 1806-9339; 1806-9339
• DOI: 10.1055/s-0037-1603939

This study aimed to evaluate and validate the qualitative human chorionic gonadotropin β subunit (β-hCG) test of the vaginal fluid washings of pregnant women with premature rupture of fetal membranes (PROM).  Cross-sectional study of pregnant women between gestational weeks 24 and 39 who underwent consultations in one of our institutions. They were divided into two groups: group A (pregnant women clinically diagnosed with PROM) and group B (pregnant women without loss of amniotic liquid). The patients were subjected to a vaginal fluid washing with 3 mL of saline solution, which was aspirated subsequently with the same syringe. The solution was immediately sent to the laboratory to perform the vaginal β-hCG test with cut-off points of 10 mIU/mL (β-hCG-10) and/or 25 mIU/mL (β-hCG-25).  The β-hCG-10 test of the vaginal secretion was performed in 128 cases. The chi-squared test with Yates' correction showed a statistically significant difference between the 2 groups (  = 0.0225). The sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy parameters were 77.1%, 43.6%, 52.3%; 70.4%; and 58.6% respectively. The β-hCG-25 test of the vaginal washing was performed in 49 cases. The analysis by Fisher's exact test showed a statistically significant difference between the groups (  = 0.0175). The sensibility, specificity, PPV, NPV, and accuracy parameters were 44.4%, 87.1%, 66.6%; 72.9%; and 71.4% respectively.  The β-hCG-25 test showed better accuracy for the diagnosis of PROM, and can corroborate the early diagnosis of PROM because it is a simple and quick exam.